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育龄期职业女性外阴阴道念珠菌病致病因素及IFN-γ、TNF-α、IL-2对其预后的预测价值

Analysis of pathogenic factors of VVC in occupational women of childbearing age and the prognostic value of IFN-γ, TNF-α and IL-2

摘要目的:分析育龄期职业女性外阴阴道念珠菌病(VVC)致病因素及IFN-γ、TNF-α、IL-2对其预后预测价值。方法:选择本院2016年6月至2017年6月妇科门诊184例患者为研究对象。采用自制一般情况调查表对患者情况进行调查,并对患者阴道分泌物取样进行镜检以诊断VVC。根据VVC患病及复发将患者分为复发组42例,未复发组55例,以非VVC患者为对照组87例。单因素分析及多因素logistic分析VVC致病的因素。结果:184例患者中共97例被确诊为VVC,发病率为52.72%。单因素分析结果显示年龄、饮用含糖饮料、吃甜食、锻炼、久坐不动、情绪状况、非经期使用护垫、穿紧身裤频率、阴道炎病史、阴道冲洗频率、刮宫史、避孕方法、首次性交年龄、性伴侣数量、性生活前后冲洗外阴与育龄期职业女性外阴阴道念珠菌病的发病有关( P<0.05)。多因素分析结果显示久坐不动、饮用含糖饮料、吃甜食、穿紧身裤频率、阴道冲洗频率、首次性交年龄、避孕方法、性伴侣数量、刮宫史、阴道炎病史、性生活前后清洗外阴均为育龄期妇女VVC患病的独立影响因素( P<0.05)。三组患者TNF-α水平对比差异无统计学意义( P>0.05),IFN-γ及IL-2水平均为复发组最低,其次为未复发组,对照组最高,差异均有统计学意义( P<0.05)。 结论:育龄期职业女性VVC的发生与久坐不动、饮用含糖饮料、吃甜食、穿紧身裤频率、阴道冲洗频率、首次性交年龄、避孕方法、性伴侣数量、刮宫史、阴道炎病史、性生活前后清洗外阴有关,临床上可对相关因素进行干预以降低该病的发病率。IFN-γ、IL-2水平降低可能增加VVC患病及复发风险。

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abstractsObjective:To investigate the pathogenic factors of vulvovaginal candidiasis (VVC) in occupational women of childbearing age and the prognostic value of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α) and interleukin (IL)-2.Methods:184 patients from the Meishan Maternal and Child Health Hospital from June 2016 to June 2017 in the gynaecological clinic were selected for research.The self-made general situation questionnaire was used to investigate the situation of the patients, and the vaginal secretions of the patients were sampled for microscopic examination to diagnose vulvovaginal candidiasis. According to the prevalence and recurrence of VVC, the patients were divided into recurrent group (42 cases), non recurrent group (55 cases) and non-VVC group (87 cases). Single factor analysis and multi factor logistic analysis were used to analyze the pathogenic factors of VVC.Results:Among the 184 patients, 97 were diagnosed as VVC, with a 52.72% incidence rate. The results of single analysis showed that age, drinking sugary drinks, eating sweets, exercising, sedentary, emotional state, frequency of using pads in non menstrual period, wearing tights, history of vaginitis, frequency of vaginal washing, history of curettage, contraceptive method, first sexual intercourse age, number of sexual partners, whether washing vulva before and after sexual life were related to the incidence of vulvovaginal candidiasis in occupational women of childbearing age ( P<0.05). The results of multivariate analysis showed that sedentary, drinking sugary drinks, eating sweets, wearing tights, vaginal washing frequency, first sexual intercourse age, contraceptive method, number of sexual partners, history of curettage, history of vaginitis, and cleaning vulva before and after sexual life were all independent factors ( P<0.05). There was no significant difference in TNF-α level among the three groups ( P>0.05), while the IFN-γ and IL-2 levels were the lowest in the recurrent group, the second in the non recurrent group, and the highest in the control group ( P<0.05). Conclusions:The incidence rate of VVC in the women of childbearing age occupation is related to sedentary, sugar drinking, sweet food, tight pants frequency, vaginal irrigation frequency, first sex, contraceptive methods, sexual partners, curettage history, vaginitis history, sexual cleansing before and after sexual activity. Clinically, relevant factors can be intervened to reduce the incidence of the disease. The decrease of IFN-γ and IL-2 may increase the risk of VVC.

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